Permit CITY OF TIGARD ELECTRICAL PERMIT
Iki ° PERMIT #: ELC2008 -00177
° COMMUNITY DEVELOPMENT DATE ISSUED: 3/28/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S1026C - 06500
SITE ADDRESS: 10640 SW PATHFINDER WAY ZONING: R -4.5
SUBDIVISION: POLO ESTATES LOT : 014 JURISDICTION: TIG
PROJECT: MCCOY
Project Description: Installation of (1) circuit for hot tub.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
COLIN MCCOY WINNER ELECTRIC INC
10640 SW PATHFINDER WAY 5950 SW PROSPERITY PK
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: 503 - 430 - 8110 Contact #: PRI • 503- 638 -5028
FAX 503- 638 -4242
FEES
Description Date Amount Reg #: ELE 34-I 50C
[ELPRMT] ELC Permit 3/28/2008 $46.85 LIC 14794
[TAX] 12% State 3/28/2008 $5.62 SUP 2825S
Total $52.47 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended fo •• - : han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rul: are set fo '• *AR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.246 -699 • r 1.800.: 2.2 ' ' .
Issued :y: H — Permittee Signat "r ,f/ „
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: - - % 111,2lV • DATE:
•
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are requited on the job site at the time of each inspection.
•
Electrical Permit Application FOR OFFICE USE ONLY
„~
-IT r �r' e ceived
City of Tigard Pe rmit N o .:
'� '� •ate/By: .3 AS /a8 Ee_A8 2
;� 11. • 13125 SW Hall Blvd., Tigard, OR 97 Plan Review
. Phone: 503.639.4171 Fax: 503.598 AR ci $ L�UU Date /By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready /By: 7° H See Page 2 for
Internet: www.tigard- or.gov ^,� nr . TI C / /6' Supplemen Information
TYPE OF WORIMatiG 1 PLAN REVIEW
❑ New construction UP Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
Demolition
❑ ❑ Other: where the available fault current
❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
21 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I - , 13
Job no.: Job site address: 10 SW > r � ( u Six or or more. occupancy.
6c
t o �e NAt, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP:
77 ❑ Health-care facilities.
0 Supply voltage for more than
ba21) on- CJ 1 a a �+ ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: The CU ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to ob site:
J D escription I Qt,•. I Fee. I Total I
New resid sing - or multi- family dwelling unit.
C1 cc t;ATp-L w -L 4 SW FO 'V Are-;e. To /07 C - Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
- Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. tt.)
Limited energy, multi - family
5b 4rhP /'o "71., (j C t 14./f? z � residential (with above sq. It) 75.00 2
Services or feeders installation. alteration. and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 _ 2
� �� 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: - ( . 5;3 ) L1& is -' Y '// 7 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder tee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 4-/(15- 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: llA,J,tf E (e, 14JG_ Signal circuit(s) or limited -
energy panel, alteration, or
Address: ' � � � extension. Describe: Page 2 ' 2
City/State /ZIP: %t;AL A'j/ Ott- q Z Each additional inspection over allowable in any of the above
6 .- ) 3 50 Z Fax: ( V3) t , Per inspection 62.50
Phone: (
6 8 5 3 � a y Investigation per hour hr min) 62.50
CCB Lie.: /.'794 Electrical Lie.: 3 /.0-0c Suprv. Lie.: a d5 ,. Industrial plant per hour 73.75
Suprv. Electrician signature, ELECTRICAL PERMIT FEES
Su
p gnature, required:
Subtotal: 44.85
Print name: 31U-14- I , r A V- Date: 3 2s-c, g Plan review (25% of permit fee):
Vet State surcharge (12% of permit fee): 5.61--
Authorized signature: TOTAL PERMIT FEE: SI Lj 7
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
a IV ...I..... .. r._... • .. II .1 .................
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B -00177
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2008
Phone: (503) 639 -4171 4 t1 i '
Inspection Requests (24 Hrs.): (503) 639 -4175 _� : IL.
INSPECTION WORKSHEET FOR DATE: 4/2/2008 TIME: 7:00AM PAGE: 67
PHA! AI ! 1o 7
SITE ADDRESS: 10&10 SW PATHFINDER WAY CLASS OF WORK:
SUBDIVISION: YOLO ESTATES LOT #: 014 TYPE OF USE:
PROJECT NAME: MCCOY
DESCRIPTION: Installation of (1) circuit for hot tub.
OWNER: MCCOY, COLIN PHONE #: 503 - 8110
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 503-638 -6028
Inspection Request Scheduled For: Date: 417!2000 Pour Time:
Code # Inspection Description Confirm # Contact # Mess- • = A
199 Electrical final 067545 -01 503-638-5028
C
Corrections /Comments /Instructions: r t_
PASS /1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL /U CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ ,
Inspector: Date: 9/Z-(eg Phone #: (503) 718 %JC